Medical Billing · Nationwide
Pediatric Neuro-Oncology & Posterior Fossa Surgery Medical Billing Services
Posterior fossa craniotomy for medulloblastoma and ependymoma, continuous intraoperative neurophysiological monitoring (IONM), stereotactic neuronavigation, ventriculoperitoneal shunt placement, and brainstem mapping.
Aethera Healthcare Solutions provides full-service medical billing and revenue cycle management to pediatric neurosurgeons, pediatric neuro-oncologists, cranial base surgical teams, and children's brain tumor centers across the United States. We handle coding, claims, payment posting, denial management, and A/R follow-up end to end — so your team can stay focused on patient care while your revenue cycle runs cleanly.
Typical pediatric neuro-oncology & posterior fossa surgery CPT range we work: 61518, 61520, 61545, 62223, 62230, 95940, 95941, 61781, 61783, 61605, 99291, 99292.
Why pediatric neuro-oncology & posterior fossa surgery billing leaks revenue
Posterior fossa craniotomy downcoding: Payer downcoding of complex infratentorial brain tumor resection (CPT 61518/61520) to simple supratentorial craniotomy (61510) with severe RVU losses
Intraoperative neurophysiological monitoring (IONM) denials: Rejection of real-time IONM time-based codes (95940/95941) due to remote monitoring log deficiencies, missing baseline comparisons, or concurrent multi-patient surveillance disputes
Neuronavigation (+61781) and ultrasonic aspiration add-on bundling: Payer denial of computer-assisted stereotactic navigation add-ons (+61781) and Cavitron ultrasonic surgical aspirator (CUSA) documentation in posterior fossa exposure
VP shunt revision bundled into tumor resection: Denial of concurrent ventriculoperitoneal shunt placement (62223) or external ventricular drain (EVD 61107) performed during the same operative session to relieve acute hydrocephalus
How Aethera fixes it
Specialty-trained coders (CPC/CCS) code to the documentation
First-pass claim scrubbing against payer and NCCI edits
Proactive denial prevention and 72-hour denial work
Relentless A/R follow-up to drive days-in-A/R down
Eligibility and prior-auth verification before service
Transparent, real-time reporting in the provider portal
Free tools for your billing team
Use these any time — no login required.
Pediatric Neuro-Oncology & Posterior Fossa Surgery billing FAQ
How is continuous intraoperative neurophysiological monitoring (IONM CPT 95940/95941) billed during pediatric craniotomies?
CPT 95940 (each 15 minutes of in-room monitoring) or CPT 95941 (each 15 minutes of remote monitoring) is billed as an add-on to the primary evoked potential codes (95925-95939). The monitoring neurophysiologist cannot be the operating neurosurgeon and cannot monitor more than three concurrent surgical cases under CMS guidelines. Documentation must reflect real-time uninterrupted continuous baseline latency and amplitude tracing notes with exact start and stop timestamps.
Can stereotactic navigation (+61781) and ventriculostomy (61107) be billed with craniotomy for infratentorial tumor (61520)?
Yes. CPT +61781 (cranial computer-assisted navigation, infratentorial) is an designated add-on code that cannot be discounted under multiple procedure reductions. When acute intracranial pressure requires placement of a pre-craniotomy external ventricular drain (61107) through a separate twist drill/burr hole, Modifier 59 (or XS) is required with explicit operative documentation demonstrating distinct site access prior to prone positioning.